89 1 97 4 B166
39 7 72 12 HAZLETON LABORATORIES AMERICA INC
76 7 97 11 9200 EESAURG TURNPIKE VIENNA VIRGINIA 22180 USA
5 8 22 10 PROJECT SHEET
16 13 28 15 Oct. 11, 1983
77 13 84 15 642-138
52 13 54 15 1
5 14 14 15 DATE ISSUED
36 14 49 15 PROJECT SHEET NO.
62 14 74 15 PROJECT NO.
69 15 72 17 
6 15 27 17 STUDY TITLE & PROPOSAL NUMBER
54 16 69 17 PROJECT COORDINATOR
70 16 84 20 D.
45 16 50 17 3212
73 16 79 17 
6 17 48 19 Acute Intraperitoneal Toxicity Study in Rats
61 18 68 19 SIGNATURE:
5 20 17 21 TEST MATERIAL(s)
54 20 62 21 LOT NO.(s)
68 20 79 21 RECEIPT DATE(s)
86 20 95 21 LH- NUMBER(s)
23 23 28 24 B166
69 23 76 25 9/28/83
85 23 92 25 20.845
6 29 22 30 PERFORMING DEPARTMENTS
23 29 40 30 4 COPIES EACH DIRECTOR)
55 29 82 31 ORIGINAL SIGNED PROJECT SHEETS TO PSO
6 30 29 31 Acute/Dermal Toxicology
61 31 76 32 FIXED DISTRIBUTION:
76 31 94 38 (1 COPY TO EACH) LAB ANIMAL MEDICINE QUALITY ASSURANCE CONTRACTS Sponsor
56 33 70 39 DIR. OF LIFE SCIENCES HEALTH SERVICES COMPOUND PREP (TOX) SCIENTIFIC RES TOX
5 35 29 37 PROTECTIVE PRECAUTIONS REQUIRED:
21 36 35 38 HAZARDOUS COMPOUND
5 39 12 40 EXPLOSIVE
27 39 40 40 CARCINOGEN (OSHA)
54 40 76 42 FOLLOW DEPARTMENT AND COMPANY SAFETY MANUALS
5 41 12 42 FLAMMABLE
27 41 41 42 CARCINOGEN (OTHER)
79 41 81 42 ☑
5 43 14 44 RADIOACTIVE
55 43 68 45 STORAGE CONDITIONS
5 45 21 46 PHYSICAL DESCRIPTION:
57 45 66 46 STORE IN DARK
82 45 90 47 DESSICATOR
57 46 70 48 REFRIGERATOR 8 C
9 47 14 48 SOLID
55 47 57 48 ☑
28 47 37 49 Colorless
82 47 88 48 FREEZER
16 48 17 49 X
37 48 42 49 COLOR
9 48 13 49 LIQUID
57 48 69 50 ROOM TEMPERATURE
82 49 86 50 OTHER
5 50 14 51 PRESSURIZED
57 50 80 51 SPECIAL INSTRUCTIONS WHILE DOSING
5 52 22 53 EXPERIMENTAL PROCEDURES
24 52 75 54 to performed in Acure/Dermal Toxicology, building 18.
11 57 50 59 The protocol for this study is attached.
12 60 69 62 The protocol was approved in sponsor letter of June 6, 1983.
12 63 71 65 The anticipated initiation date of this study is October 1983.
11 65 71 68 The anticipated completion date of this study is November 1983.
90 81 93 90 00866042
6 96 16 98 ML FORM NO. 5 REVISED 1- 81
